Rotary rehabilitation apparatus and method
A rotary rehabilitation apparatus for rehabilitation of a person's extremity, including the joints and assorted muscles, tendons, ligaments, that can be tailored to the person's needs based upon their physical size, type of injury, and plan for recovery. The apparatus facilitates the adjustment of the range of motion of the user's extremity in a cycling action by offsetting a moveable lever from a fixed lever at a plurality of angles. As the user's extremity moves in a circular path, the extremity engages in extension and flexion to cause movements in the articulations formed at the user's joints.
1. Field of the Invention
This invention relates generally to the field of exercise and rehabilitation, and more specifically, to an apparatus providing selective adjustment of the range of motion of a user's extremities, including either arms and legs, actively engaging in or passively participating in a cycling action.
2. Description of the Related Art
One of the most significant and the most common athletic injuries is to the knee, and published data continues to report at an incidence of between one-quarter and one-third of all men and women experience some type of knee injury annually. Approximately 10.8 million individuals visit a physician for knee injuries alone each year. Total estimated annual U.S. costs of all musculoskeletal conditions is $254 billion. Many injuries to the lower extremities of persons necessitate the use of rehabilitation exercises. Such injuries may include those to the joints of a person's leg (e.g., knee, hip), replacement of one's joint (e.g., total hip or knee arthroplasty [THA, TKA]), ligaments or tendons associated with these joints (e.g., anterior cruciate or medial collateral ligament [ACL, MCL], or patella or quadricepts tendons), or muscles of the leg (e.g., Rectus or biceps femoris, etc). Rehabilitation exercises are also frequently prescribed after surgery has been performed to further repair an injured site on a user's extremity.
Major trunk injuries are also exceedingly common in the United States. Major trunk injuries include those injuries that affect the shoulders and back. The shoulder joint, being the most flexible joint in the human body, can be easily injured because of accidentally over-extending the range of motion. The U.S. Department of Labor estimates that thirty-five percent of all muscoskeletal injuries are major trunk injuries. Over four million visits are made to health care professionals each year because of shoulder injuries. Moreover, the U.S. Department of Labor estimates that the average time off-work for shoulder injuries is twelve days. This corresponds to an estimated $13–20 billion due to time lost from work.
One common rehabilitation exercise recommended to improve muscle, ligament and tendon strength, and endurance for extremities post-injury or post-surgically, is movement in a cycling motion. The movement of a person's upper or lower extremity in a circular path induces motion in the articulations that form the shoulder and elbow or hip and knee, respectively. However, for rehabilitation to be effective, it must be tailored to the specific needs of a given person based on their physical size, type of injury, and plan for recovery, among other factors. For example, if a surgical repair has been made to a torn ACL of a person's leg, it is often desirable at the beginning of a rehabilitation regimen to limit the flexion or extension of the knew, due not only to pain, but also to avoid damage to the repair. Likewise, for the shoulder, a physician may recommend limiting the motion of the shoulder to something far less than its full capability of 360 degrees until natural recovery and sufficient rehabilitation has occurred. Although cycle-type exercise machines are recommended for use in certain rehabilitation regimens, they generally do not facilitate the adjustment of the range of motion of one individual extremity. Further, these machines are limited to the standard pedal or handle arrangement where one lever (handle or pedal) is offset from the other by 180 degrees around a hub. There are, however, rehabilitation regimens where benefits to flexibility, strength, and/or endurance are achieved by offsetting levers or handles at another angles for passive, assisted active, and active range of motion.
SUMMARY OF THE INVENTIONA rotary rehabilitation apparatus is presented that allows for the selection of a range of motion for upper and/or lower extremities of a person engaging in a cycling action. The adjustable lever assembly allows for safer, more immediate rehabilitation following hip, knee, shoulder, and/or elbow injuries and further provides for pain reduction, increasing the range of motion, strengthening soft tissue and general conditioning. The assembly comprises one movable lever and a flywheel rotatably mounted on a support and having a series of bores along a diameter thereof with which the movable lever or handle is releasably mounted. In an exemplary arrangement where the rotary rehabilitation apparatus is incorporated with cycle-type exercise machine, for example a cycle ergometer, a user will sit on the seat and place their feet or hands on the levers to impart a force thereon. As the user's feet or hands move in a circular path, the extremities engage in extension and flexion to cause movement in the articulations formed at the user's hip and knee or shoulder and elbow joints. The amount of movement in the articulations of the extremity and consequently, the range of motion at these joints can be controlled by mounting the lever with the appropriate bore on the flywheel. If increased extension and flexion is desired, the lever can be mounted with a bore further away from the axis of rotation of the flywheel. Conversely, if a smaller degree of extension and flexion is preferred, the lever can be mounted with a bore closer to the flywheel axis of rotation.
In one configuration, the moveable lever is releasably mounted with a mounting bore of the flywheel and the other lever is left at full diameter. This configuration allows an adjustable range of motion for one extremity and a fixed range of motion for the other extremity, which allows for more limited, rehabilitative exercises for one extremity (e.g., an injured knee or shoulder) and more robust exercises for the other.
In another aspect, more than one series of bores extend across different diameters of the flywheel, so that the movable lever can be mounted at various angles with respect to the fixed lever around the axis of rotation. For example, while levers are typically aligned 180 degrees from one another around a hub on an cycle-type exercise machine, it may be desired in rehabilitation regimens to position the levers at a different angle to work on the passive range of motion (“PROM”), the assisted active range of motion (“AAROM”), and the active range of motion (“AROM”).
The rotary rehabilitation apparatus of the present invention provides improved options for rehabilitation regimes where a cycling or rotary action would be beneficial to recovery from injury of a person's extremities. As a user progresses in their injury recovery, such as by increasing strength and flexibility in their extremities, the movable lever or handle can be disengaged and remounted within another bore that provides a different range of motion for their extremity when rotating the assembly.
By rapidly affecting PROM, AAROM and AROM this invention will reduce the time required to recover from extremity injuries, increasing improvements in measurable outcomes such as range of motion, edema, proprioception, return to unassisted gait activities, initial functional independent measures, strength and conditioning; reduce overall inpatient and outpatient costs, accelerate return to vocational or avocational activities; and significantly improve quality of life by expediting a return to autonomy.
One rotary rehabilitation apparatus 10 providing for the selection of a range of motion for one or both legs 200 of a person is shown in
The adjustable range of motion for each leg 200 is achieved by having the movable lever 12a be repositionable along one or more diameters of the flywheel 14. The flywheel 14 has a series of bores 16 extending laterally therethrough parallel to the flywheel rotational axis and formed in a row along the flywheel diameter so that the lever 12a can be removably mounted with one of the bores 16. In the embodiment of the rotary rehabilitation apparatus 10 shown in
Depending on the functionality desired in the cycle-type exercise machine 100, the flywheel 14 can be designed to have a relatively large or small moment of inertia. A large moment of inertia flywheel 14 requires more peddling force to accelerate the same to a given speed, but also causes the flywheel 14 to better resist changes in speed, resulting in smoother “steady-state” cycling, which may be preferred in certain rehabilitation exercises. The higher moment of inertia is created by making the flywheel 14 heavier and/or moving more of the flywheel weight out to the circumferential ring 30.
The flywheel 14 is mounted with the hub 20 by insertion of a fastener 39 through the bore 16 of the disk 22 forming the center point 15 of the flywheel 14 and through a coupling 40 for securing with the hub 20. Specifically, the fastener 39 extends into a receiving bore 42 formed in a stem 44 rotatably mounted within a body 46 of the hub 20. In this arrangement, the hub body 46 is stationary on the support 102 while the hub stem and the mounted flywheel 14 rotate relative to the hub body 46. The hub 20 is preferably mounted adjacent to the first planar surface 24 on a side of the flywheel 14 opposite of the movable lever 12a.
In addition to controlling the moment of inertia in the flywheel 14, the overall resistance to turning of the flywheel 14 may be controlled to increase the amount of work a user must perform in peddling, as those of skill in the art appreciate with respect to known cycle-type exercise machines. For example, frictional resistance may be incorporated in to the design of the hub 20, such that the rotation of the stem 44 relative to the hub body 46 requires a certain amount of force to overcome the static and dynamic friction within the hub 20. Alternatively, a frictional surface (not shown), for example, a brake, may selectively engage the circumferential ring 30 to create static and dynamic friction.
The motion of a person's legs 200 utilizing the rotary rehabilitation apparatus 10 of the present invention is simulated in
This rehabilitation regimen may be recommended when the user is not to bend their leg to a certain degree, for example, to limit stresses on the hip 206 or knee 210. Conversely, in
In the embodiment of the rotary rehabilitation apparatus 218 shown in
Claims
1. An apparatus providing an adjustable range of motion for an extremity of a user, comprising:
- a support including an arm extending therefrom;
- a flywheel rotatably mounted on the arm for rotation about a first axis, the first axis being at least substantially perpendicular to the arm, the flywheel having a first plurality of horizontally aligned bores disposed along a diameter thereof;
- a first lever configured for being releasably mounted in one of the bores of the first plurality of bores on a side of the flywheel, such that releasably mounting the first lever in a different bore of the plurality of bores changes the path of motion of the user's extremity positioned on the first lever thereby altering the range of motion of the articulation forming the user's joints on the respective extremity of the user;
- a seat positioned rearward of the flywheel, the seat at substantially the same elevation as the flywheel, such that a user seated on the seat may place one of their extremities on the first lever to rotate the flywheel;
- a hub in operative communication with the support, the hub including a rotatable member for imparting rotational motion to the flywheel, about a second axis, the second axis being at least substantially coaxial with the first axis; and,
- a crank in operative communication with the rotatable member of the hub, the crank being positioned on a side of the flywheel opposite of the first lever.
2. The apparatus of claim 1, further comprising:
- a second lever rotatably mounted with the crank such that a user may rotate the flywheel by imputing forces on the first lever and second lever with the extremity.
3. The apparatus of claim 1, further comprising a second plurality of horizontally aligned bores bisecting the first plurality of bores on the flywheel, along a diameter thereof, the second plurality of bores extending orthogonally from the first plurality of bores.
4. The apparatus of claim 1, further comprising a plurality of horizontally aligned bores bisecting the first plurality of bores on the flywheel along a diameter thereof, each of the plurality of bores in linear alignment at an angle with respect to the other plurality of bores.
5. The apparatus of claim 1, wherein the first lever has a bore extending laterally from a medial lever side face to a lateral lever side face opposite thereof, the means for releasably rotatably mounting the first lever with one bore comprises:
- a sleeve configured to fit within the lever bore; and
- a pin insertable through the sleeve on the lateral lever side face and extending out of the medial lever side face, the pin having a protrusion for engaging with one horizontally aligned bore of the flywheel.
6. The apparatus of claim 1, wherein the flywheel comprises:
- a circular plate having opposing planar surfaces and a perimeter edge;
- a ring sized to fit around the perimeter edge of the circular plate and having an inner edge; and
- a brace member extending across one of the planar surfaces of the plate to span the inner diameter of the ring.
7. A method for selectively adjusting the range of motion of articulations formed from the joints of an extremity of a user engaging in a cycling action, comprising the steps of:
- providing a seat whereon a user may sit;
- providing a support including an arm extending therefrom;
- providing a flywheel rotatably mounted on the arm, the flywheel positioned forward from the seat, the flywheel configured for rotation about a first axis, the first axis being substantially perpendicular to the arm, and the flywheel having a first plurality of bores extending in a direction parallel to the axis of rotation and disposed along a diameter of the flywheel;
- positioning the seat such that the seat is at least at substantially the same elevation as the flywheel:
- providing a lever configured for releasably mounting with one of the bores of the flywheel;
- providing a hub in operative communication with the support, the hub including a rotatable member for imparting rotational motion to the flywheel about a second axis, the second axis being at least substantially coaxial with the first axis;
- providing a crank in operative communication with the rotatable member of the hub, the crank being positioned on a side of the flywheel opposite of the first lever;
- mounting the lever with one particular bore of the flywheel to select the desired articulating motion of the user's joints on the respective extremity of the user when the user's extremity is placed on to lever and a force is applied thereto; and,
- creating a force on the crank to activate the hub and impart rotational motion to the flywheel.
610157 | August 1898 | Campbelle |
4446753 | May 8, 1984 | Nagano |
4509742 | April 9, 1985 | Cones |
4606241 | August 19, 1986 | Fredriksson |
4850245 | July 25, 1989 | Feamster et al. |
5161430 | November 10, 1992 | Febey |
5316532 | May 31, 1994 | Butler |
5361649 | November 8, 1994 | Slocum, Jr. |
5458022 | October 17, 1995 | Mattfeld et al. |
5580338 | December 3, 1996 | Scelta et al. |
5860941 | January 19, 1999 | Saringer et al. |
6053847 | April 25, 2000 | Sterns et al. |
6589139 | July 8, 2003 | Butterworth |
8519150 | October 1985 | DE |
19947926 | April 2001 | DE |
1034817 | September 2000 | EP |
Type: Grant
Filed: Oct 16, 2003
Date of Patent: Jun 5, 2007
Patent Publication Number: 20050085346
Inventor: Kenneth W. Johnson (Pittsburg, KS)
Primary Examiner: (Jackie) Tan-Uyen Ho
Assistant Examiner: Tam Nguyen
Application Number: 10/687,207
International Classification: A63B 22/06 (20060101);